Study Materials

UNC Health Registry Brochures in English & Spanish: Click here to view the HIPAA Authorization. The purpose of the UNC Health Registry is to better understand the causes of disease, which affect many North Carolinians. Our goal is to conduct research that will find better ways to treat common health issues, help patients live fuller lives and ultimately find ways to prevent illnesses. Thank you for being a part of the UNC Health Registry.

Informed Consent: Click here to view the Informed Consent Document. The purpose of this research is to collect information and biologic specimens from a large group of people who are seeking care at UNC. Research with specimens can help researchers understand how the human body works. Studies of large groups of people over long periods of time help researchers understand causes, treatments and methods for disease prevention. To join the study is voluntary. You may refuse to join, or you may withdraw your consent to be in the study, for any reason.

Research is designed to obtain new knowledge that may help other people in the future. Your contribution of time, energy and specimens to this study will help our researchers better understand the causes, treatments and prevention of disease, as well as ways to improve health care and quality of life. Future generations may benefit from the results and knowledge gained from this research. Thank you for participating.

UNC Health Registry Informed Consent Video: Click here to view a video that further explains the purpose of the UNC Health Registry. We hope that you will consider being a part of this exciting, new initiative to improve and possibly save the lives of many North Carolinians. If you are interested in participating in this research study, please call 1-877-783-2358 or email unchealthregistry@med.unc.edu to find out more information.

HIPAA Authorization: Click here to view the HIPAA Authorization. This is a permission called a “HIPAA authorization.” It is required by the “Health Insurance Portability and Accountability Act of 1996” (known as “HIPAA”) in order for us to access information from your medical records or health insurance records to use in this research study.

UNC Health Registry Baseline Questionnaire: Click here to view the UNC Health Registry Baseline Questionnaire. All participants enrolled in UNC Health Registry are eligible to complete the baseline general questionnaire. Interviews may be conducted over the phone or in-person on the day of a clinic visit. The baseline general interview takes approximately 45 minutes and covers topics such as: Who you are (gender, age), your health history, lifestyle choices, quality of life, your access to health care and your relationship with your healthcare team.